Objective and Subjective Measurement of Cough in Asthma: A Systematic Review of the Literature

Abstract

Background The extent to which objective and subjective tools has been used to measure the characteristics and burden of cough in patients with asthma has not been reported. Objective To review the large and extensive body of literature in asthma with the specific hypothesis that the characteristics of cough and clinical impact in this disease has only occasionally been studied. Methods For this systematic review, we searched EMBASE and MEDLINE databases using a combination of MeSH terms for “cough” and “asthma” for studies published up to and including end of August 2021. Studies included for analysis were confined to those undertaken in adult patients (≥ 18 years) with asthma of any severity where any tool or method to specifically measure cough was employed. Results Of 12,090 citations identified after our initial search, 112 full-text articles met criteria for inclusion in our analysis. We found that a broad range of objective and subjective measures have been used albeit with a lack of consistency between studies. Clinically important levels of cough associated with impaired health status were identified in patients with asthma. Conclusion Although cough is a common symptom in asthma, the clinical features and accompanying healthcare burden have been studied infrequently. In studies where cough was measured, the methods employed varied considerably. A more consistent use of cough-specific measurement tools is required to better determine the nature and burden of cough in asthma.

The illness burden of severe asthma contrasted to people with mild-to-moderate asthma: a qualitative study

“…Asthma assessment tools to capture symptom control and physical and emotional impacts of asthma are used in asthma studies and practice [ 28 – 30 ]. However, these questionnaires have few cough items and therefore may not fully capture the burden of cough in severe asthma [ 21 , 22 , 31 ].…”

“…Our study provides additional evidence to support the impact of severe asthma on overall wellbeing. Given the burden profile of severe asthma, this could mean that whilst evaluating the quality of life is important in both groups, a universal asthma assessment tool may not capture the true burden of people with severe disease [ 9 , 10 , 12 , 31 ].…”

Evolving Concept of Severe Asthma: Transition From Diagnosis to Treatable Traits

“…Cough is a major symptom during asthma exacerbation causing severe distress, but has not been well investigated for its clinical relevance in the context of severe asthma. 46 80 81 Cough is more frequent in severe asthma than in non-severe asthma and associated with worse health-related QoL and asthma control. 81 Mechanisms underlying cough may overlap with, but are distinct from those of wheezing or breathlessness.…”

LUNG Year in Review: 2022

“…Clinical studies of COPD examined diagnosis [ 2 ], risk factors [ 3 ], predictors of outcomes [ 4 – 9 ], and therapeutic interventions [ 10 , 11 ], whereas preclinical investigations evaluated chronic cigarette smoke-induced inflammation and airway remodeling [ 12 , 13 ]. Contributions in the field of asthma included physiological studies [ 14 – 18 ], effects of therapeutic interventions [ 19 ], social determinants of clinical outcomes [ 20 ], asthma-associated cough [ 21 , 22 ] and preclinical investigations [ 23 ].…”

“…Indeed, 2022 witnessed the approval of the first-ever drug indicated for the treatment of refractory chronic cough [ 51 , 52 ]. LUNG continued its emphasis on high-quality cough-related research by featuring numerous articles, including those examining asthma-associated cough [ 21 , 22 ]; cough associated with IPF [ 53 ] and COVID19 [ 54 ]; methodology of objective cough counting [ 55 , 56 ]; cough-related healthcare utilization [ 57 , 58 ]; physiology [ 59 ]; and, studies of potential antitussive drugs [ 60 – 62 ].…”